Abstract

VHH stands for the variable regions of heavy chain only of camelid IgGs. The VHH family forms a set of interesting proteins derived from antibodies that maintain their capacity to recognize the antigen, despite their relatively small molecular weight (in the 12,000 Da range). Continuing our exploration of the possibilities of those molecules, we chose to design alternative molecules with maintained antigen recognition, but enhanced capacity, by fusing four VHH with one Fc, the fragment crystallizable region of antibodies. In doing so, we aimed at having a molecule with superior quantitative antigen recognition (×4) while maintaining its size below the 110 kDa. In the present paper, we described the building of those molecules that we coined VHH2 -Fc-VHH2 . The structure of VHH2 -Fc-VHH2 in complex with HER2 antigen was determined using electronic microscopy and modeling. The molecule is shown to bind four HER2 proteins at the end of its flexible arms. VHH2 -Fc-VHH2 also shows an internalization capacity via HER2 receptor superior to the reference anti-HER2 monoclonal antibody, Herceptin®, and to a simple fusion of two VHH with one Fc (VHH2 -Fc). This new type of molecules, VHH2 -Fc-VHH2 , could be an interesting addition to the therapeutic arsenal with multiple applications, from diagnostic to therapy.

Highlights

  • HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not

  • We read with great interest the article by Jaradat et al, entitled “Stereotactic biopsies of brainstem lesions: which approach?” [4]

  • Single-center cohort on 23 adult patients, the authors report a high diagnostic yield (91%) and a low rate of complications, and discuss the best approach to target brainstem lesions. They recommend a supratentorial transfrontal approach for midbrain lesions, a transcerebellar-transpeduncular route for pontine lesions and for the lesions located in the upper part of the medulla oblongata, and a transfrontal trajectory for the other medullary lesions

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Summary

Introduction

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. Stereotactic biopsies of brainstem lesions: dilemma on the best trajectory Bertrand MATHON, MD1,2; Henri MALAIZE, MD1; Aymeric AMELOT MD, PhD1,3. 1. Department of Neurosurgery, APHP - Sorbonne University, La Pitié-Salpêtrière Hospital, Paris, France. 3. Department of Neurosurgery, Bretonneau Hospital, Tours, France.

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